haemorrhoids Flashcards

1
Q

what are haemorrhoids

A

enlarged anal vascular cushions

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2
Q

assocw

A
constipation + straining 
pregnancy 
obesity 
inc age
inc intra abdo pressure
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3
Q

why can they often occur in pregnancy

A

constipation
pressure from baby in pelvis
effects of hormones relaxing connective tissues

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4
Q

what are anal cushions

A

specialised submucosal tissue than contain connections between arteries and veins (so V vascualr)

help control anal continence

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5
Q

anal cushion blood supply

A

rectal arteries

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6
Q

where are anal cushions usually locates

A

3, 7 + 11 o’clock

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7
Q

classification: 1st degree

A

no prolapse

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8
Q

classification: 2nd degree

A

prolapse when straining + return on relaxing

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9
Q

classification: 3rd degree

A

prolapse when straining

doesn’t return on relaxing but can be pushed back

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10
Q

classification: 14h degree

A

prolapsed permanently

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11
Q

symptoms

A

painless, bright red bleeding: not mixed with stool
sore/itchy anus
feeling lump

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12
Q

on examination

A

external/prolapsed: visible on inspection

internal: may be felt onPR

may appear/prolapse if patient bears down

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13
Q

Mx - topical treatments

A

anusol
anusol with hydrocortisone
gremoloids cream (has lidocaine)
proctosedyl ointment

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14
Q

Mx - prevention and treatment of constipation

A

inc fibre
good fluid intake
laxatives
avoid straining

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15
Q

Mx- non surgical

A
  • rubber band ligation
  • injection sclerotherapy
  • infra-red coagulation
  • bipolar diathermy
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16
Q

Mx - surgical options

A
  • haemorrhoidal artery ligation
  • haemorrhoidectomy
  • stapled haemorroidectomy
17
Q

risk with haemorrhoidectomy

A

faecal incontinence

18
Q

thrombosed haemorrhoids

A

caused by strangulation at base of haemorrhoid resulting in thromboss in haemorrhoid

19
Q

thrombosed haemorrhoids presentation

A

purple, very tender, swollen lumps around Anus

very painful